Covid-19 Infection in Uterus Transplant Recipients in the Us

ABSTRACT

Objective: The ongoing COVID-19 pandemic has been associated with greater risk of infection and severe complication in solid organ transplant recipients compared to the general population, yet sparse data exists on the effect of COVID-19 on uterus transplant (UTx) recipients. Though immunosuppressed individuals, including organ transplant recipients, experience higher rates of morbidity and mortality following COVID-19 infection, vaccination for COVID-19 has been shown to effectively reduce mortality for these patients. Despite these encouraging results, and statements from professional societies including ASRM recommending vaccination, vaccine hesitancy remains elevated in the infertility population. The goal of this report is to provide details regarding COVID-19 infection and vaccination rates in UTx recipients in the US. Material(s) and Method(s) We performed a retrospective cohort analysis on individuals who have undergone UTx as of March 2021 in the US. Five UTx recipients at two centers (Baylor Scott and White, Dallas, Texas, and Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania) were diagnosed with COVID-19 infection as defined by the presence of a positive SARS-CoV-2 on reverse transcriptase-polymerase chain reaction (RT-PCR) testing from a nasopharyngeal swab. Data collected included demographic features, transplant history, transplant-related complications, vaccination status and pregnancy history. Result(s) The median time from transplant to diagnosis of COVID-19 was 22.8 months. Despite the availability of the COVID-19 vaccine, only one out of 5 UTx recipients was vaccinated at the time of diagnosis. Two recipients were pregnant at the time of diagnosis, one in the first trimester and one in the second trimester of pregnancy. One recipient experienced COVID reinfection three months following the first infection. All COVID positive UTx recipients experienced no or mild symptoms;one recipient was asymptomatic, 4 had nasal congestion, 2 had headaches, and one patient was febrile. Four recipients received Casirivimab-imdevimab. In 80% of patients, no changes were made to patients' immunosuppression regimens. Conclusion(s) All UTx recipients who were diagnosed with COVID-19 infection as of 3/2021 recovered without complications. As in other infertility patients, vaccine hesitancy remains a significant concern despite the UTx population having a higher risk of severe disease. Data continues to accrue demonstrating the safety of vaccination in pregnancy, and communication of these results to the UTx population is essential to promote maternal and child health. Impact Statement This data provides reassuring information regarding outcomes for COVID-19 infection in UTx population;however also demonstrate that similar to other pregnant patients or patients with infertility, vaccine hesitancy remains a significant issue. Copyright © 2022